{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T19:41:18Z","timestamp":1779306078574,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,1,4]],"date-time":"2018-01-04T00:00:00Z","timestamp":1515024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,1,4]],"date-time":"2018-01-04T00:00:00Z","timestamp":1515024000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Total thyroidectomy can be performed for Graves\u2019 disease after a euthyroid state is achieved using inhibitors of thyroid hormone synthesis (thioamides). However, hypervascularization of the thyroid gland is associated with increased hemorrhage risk, in addition to complicating identification of the recurrent laryngeal nerve and parathyroid gland. Saturated iodine solution (Lugol\u2019s solution) has been recommended to reduce thyroid gland hypervascularization and intraoperative blood loss, although this approach is not used at our center based on our experience that it induces thyroid firmness and potentially hypoparathyroidism.\n<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective single\u2010center study evaluated patients who underwent total thyroidectomy for Graves\u2019 disease between November 2010 and November 2015. The rates of various complications at our center were compared to those from the literature (e.g., cervical hematoma, hypocalcemia, and recurrent laryngeal nerve palsy).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three hundred and eighty consecutive patients underwent total thyroidectomy without preoperative Lugol\u2019s solution (311 women [81.84%] and 69\u00a0men [18.16%], mean age 43.41 years). No postoperative deaths were reported, although 30 patients (7.89%) experienced recurrent laryngeal nerve palsy and 9 patients experienced permanent injuries (2.37%). Hypoparathyroidism was experienced by 87 patients (25.53%) and 14 patients experienced permanent hypoparathyroidism (3.68%). Four patients required reoperation for cervical hematoma (1.05%; 2 deep and 2 superficial hematomas).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite the recommendation of iodine pretreatment, few of our non\u2010pretreated patients experienced permanent nerve injury (2.37%) or permanent hypoparathyroidism (3.68%). These results are comparable to the outcomes from the literature. Randomized controlled trials are needed to determine whether iodine pretreatment is necessary before surgery for Graves\u2019 disease.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-017-4443-3","type":"journal-article","created":{"date-parts":[[2018,1,4]],"date-time":"2018-01-04T15:27:49Z","timestamp":1515079669000},"page":"2123-2126","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Does Surgery Without Lugol\u2019s Solution Pretreatment for Graves\u2019 Disease Increase Surgical Morbidity?"],"prefix":"10.1002","volume":"42","author":[{"given":"Frederic","family":"Mercier","sequence":"first","affiliation":[{"name":"The Department of Digestive and Endocrine Surgery, CHU Lyon Sud, Hospices Civils de Lyon University of Lyon 165 Chemin du Grand Revoyet 69495 Pierre B\u00e9nite 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Performance Research Universit\u00e9 Claude Bernard Lyon 1 Domaine Rockefeller\u2010 4eme \u00e9tage (aile CD), 8 Avenue Rockefeller 69373 Lyon 8 France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,4]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(16)00278\u20106"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0229"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lpm.2011.09.012"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.332.7554.1369"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010015\u20103298\u20108"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007\u20100229"},{"issue":"1","key":"e_1_2_8_8_2","doi-asserted-by":"crossref","first-page":"S16","DOI":"10.1016\/S0003-4266(16)30010-5","article-title":"Is it possible to limit the 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